CW: Dental Care:
For the first time in Nevada, Medicaid is expanding dental treatment to adults with intellectual and developmental disabilities. The expansion was made possible thanks to $2.5 million in ARPA funds and a Federal Title 19 grant. According to a new website, Every Smile Matters, launched by Nevada Medicaid, dental clinics are not required to accept patients with disabilities.
Many dentists do not have the training required to provide care to people with developmental and intellectual disabilities. Additionally, low Medicaid reimbursement rates also prevent dentists from accepting Medicaid as insurance.
Martha Chisam, a retired school van driver, and her disabled son Danny, who’s in his 50s live in Massachusetts. Unfortunately, Chisam is having trouble finding someone to do the dental work Danny requires right now, whether it’s an office that accepts his insurance or a dentist who will put him to sleep with anesthesia to fill a cavity.
A 2020 report published by the International Journal of Dentistry found that barriers to oral healthcare for disabled people included the cost of treatment, the dentist’s lack of preparation for dental care of disabled people, a lack of dental facilities that were accessible to the disabled, and the absence of accessible transportation to health care facilities and dental offices.
People with intellectual and developmental disabilities often struggle to receive dental care. According to a 2012 report from the Journal of the American Dental Association, a study of 4,732 adults with intellectual and developmental disabilities found that the frequency of untreated cavities was 32.2%, periodontitis was 80.3%, and edentulism was 10.9%. The average amounts of missing teeth, decaying, missing, and filled teeth, respectively, were 1.0 (2.2), 6.7 (7.0), and 13.9 (7.7).
Additionally, according to a 2022 report from The National Council on Disability, nearly 4.5 million of the 7.3 million persons in America with intellectual and developmental disabilities rely on Medicaid for health insurance. The National Council on Disability found that Medicaid does not consistently give adults with I/DD dental care and that twelve states, except for seven states that have restricted waiver programs, do not provide basic dental benefits.
The report also found that poor oral health has been associated with disorders such as diabetes, hypertension, and other cardiovascular, endocrine, and respiratory problems. Oral pain can interfere with eating, sleeping, and communication. It can also lead to low self-esteem.
Disabled people deserve access to accessible, dental care. Quality healthcare services are essential to ensuring that disabled people are healthy and comfortable. The lack of affordable, accessible, dental care can in the U.S. can result in people having poor oral health due to their disabilities.
da Rosa, Saulo V et al. “Barriers in Access to Dental Services Hindering the Treatment of People with Disabilities: A Systematic Review.” International journal of dentistry vol. 2020 9074618. 23 Jul. 2020, doi:10.1155/2020/9074618
Lannan, Katie. “Unpaid Caregivers Urge Healey to Get More Support to Families.” WGBH, WGBH Educational Foundation, 7 Apr. 2023, https://www.wgbh.org/news/politics/2023/04/07/unpaid-caregivers-urge-healey-to-get-more-support-to-families.
“Medicaid Oral Health Coverage for Adults with Intellectual & Developmental Disabilities – a Fiscal Analysis.” The National Council on Disability, The National Council on Disability, 9 Mar. 2022, https://ncd.gov/publications/2022/medicaid-oral-health-coverage-adults-IDD.
Morgan, John P et al. “The oral health status of 4,732 adults with intellectual and developmental disabilities.” Journal of the American Dental Association (1939) vol. 143,8 (2012): 838-46. doi:10.14219/jada.archive.2012.0288
Todd, Camalot. “Nevada Medicaid Expands Dental Care Access for Adults with Disabilities;” Nevada Current, States Newsroom, 5 May 2023, https://www.nevadacurrent.com/2023/05/05/nevada-medicaid-expands-dental-care-access-for-adults-with-disabilities/.